How many patients to for center to stay open

[XRT_doc]

Generally how many patients under treatment are necessary for a center to not be losing money. Assume medicare/medicaid patients, single linac, typical crew, and a paid off linac.

---

Members don't see this ad.

 

[Gfunk6]

Very hard to say, depends on a multitude of factors.

A fast and dirty range would be 10-15 per day.


Sent from my iPhone using SDN mobile

 

[medgator]

What's a typical crew? Multiple centers that can share a dosimetry/physics team and a CT SIM? RN or medical assistant?

Could get it down to single digits if resources can be shared with other centers and you go with an LPN or MA instead of an RN. Can flex a second person from other centers to help cover the front desk and clinic when needed from a staffing perspective.

 

[Reaganite]

I agree with Medgator--you could run a center (potentially even a profitable one) with single digit patients under the right circumstances. Shared resources, skeleton crew, etc.

 

[RadOncDoc21]

Sounds like a Florida gig

 

[nkmiami]

I agree with Medgator--you could run a center (potentially even a profitable one) with single digit patients under the right circumstances. Shared resources, skeleton crew, etc.

Probably with a linac that should not be treating human pts. Certainly not with new equipment and decent software

 

[medgator]

Probably with a linac that should not be treating human pts. Certainly not with new equipment and decent software

Sounds like how the NCI-designated ivory tower academicians throw shade at community docs.

Not every center in a multi-center practice needs a truebeam running the latest version of aria. Send the srs sbrt cases to your main center. There are podunk centers advertising gigs in the Midwest running things on trilogy and iX platforms... Must be malpractice huh?

 

[nkmiami]

not at all. Ix with cone beam can do 99%
-100%of what truebean does, but For a linac w/ conebeam, vault, service contract on that linac, software, service on that software, you are talking a lot of money and I don’t see how you could make ends meet on under 10 pts if you are taking into account all costs.
Ex: service contract on linac easily 200k/year. Service contract on a couple of eclipse aria licenses abt the same. just service contract on ct sim is like 60,000/year

Yes, if someone gave you all the equipment, and you just had to run the place maybe, but not if you factor in purchasing all the equipment ,software , construction etc

 

[medgator]

not at all. Ix with cone beam can do 99%
-100%of what truebean does, but For a linac w/ conebeam, vault, service contract on that linac, software, service on that software, you are talking a lot of money and I don’t see how you could make ends meet on under 10 pts.

Buy gently used with a good inspection, third party service contract.

I'll give you the vault issue though. I believe Medicare cut that expense in their calculation a few years ago.

I will agree it is tough for a sole single linac practice to make it all work on 10 or less patients a day, especially if you are trying to start up a place now vs keeping an existing practice going. It is more reasonable in a multi site practice where resources are being shared like physics, dosimetry, CT SIM, therapists etc

 

[seper]

I know of a 3 single-digit "rural" centers, all owned by the same large hospital, subsidized by the mother center in the town. So "losing" money is not a straightforward concept.

 

[medgator]

I know of a 3 single-digit "rural" centers, all owned by the same large hospital, subsidized by the mother center in the town. So "losing" money is not a straightforward concept.

I bet some of those centers probably generate additional downstream revenue like brachy, srs/sbrt and imaging so it is worth it for the hospital system to keep them going

 

[seper]

Possible. It does, however, presume a very sophisticated level of fair accounting, which I doubt.

I bet some of those centers probably generate additional downstream revenue like brachy, srs/sbrt and imaging so it is worth it for the hospital system to keep them going

 

[nkmiami]

Possible. It does, however, presume a very sophisticated level of fair accounting, which I doubt.

T

I bet some of those centers probably generate additional downstream revenue like brachy, srs/sbrt and imaging so it is worth it for the hospital system to keep them going

I doubt they make a whole lot downstream. The mission of a lot of nonprofits is not to make money, so unless they are under a lot of stress, they may not close anything.

 

[Gfunk6]

Based on the numerous anecdotes that were posted here, I think the bottom line answer to the OP is: NEED MORE DATA

 

[medgator]

T

I doubt they make a whole lot downstream. The mission of a lot of nonprofits is not to make money, so unless they are under a lot of stress, they may not close anything.

You should see the facilities at places like mayo, ccf, Adventist etc. Non profits do in fact make a ton of money and have well paid executives and well appointed facilities/infrastructure in many cases.

 

[seper]

I've worked for a non-profit (as an employed attending) and I can say that they are absolutely out to get money. There are loopholes in non-profit designations. Politicians have to fix it.

 

[Mandelin Rain]

It's not too hard for a non-profit hospital system to run a multitude of for-profit entities to service the system. Need medical supplies? We have a medical supply company. Need a cafeteria? Turns out we also own a dietary company. Need to hire people? Let our HR company take care of that for you.

Shifting money from the non-profit pocket to the for-profit pocket has never been easier.

Non-profit is one of the biggest misnomers going.

 

[nkmiami]

A lot of non profits are very financially aggressive, but not all. That is basically what I am saying.

 

[RadOncDoc21]

The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System.
Du JY, et al. Clin Orthop Relat Res. 2018

The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System. - PubMed - NCBI

 

[medgator]

The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System.
Du JY, et al. Clin Orthop Relat Res. 2018

The Growing Executive-Physician Wage Gap in Major US Nonprofit Hospitals and Burden of Nonclinical Workers on the US Healthcare System. - PubMed - NCBI

The real question from a management standpoint is who has the best lobbyists in DC...

 

[OTN]

T

I doubt they make a whole lot downstream. The mission of a lot of nonprofits is not to make money, so unless they are under a lot of stress, they may not close anything.

Health economics data shows not-for-profit hospitals and for-profit hospitals both operate in the exact same way, to maximize their financial returns. With for-profit hospitals that return goes back to the shareholders, while in not-for-profit hospitals it is returned back to the facility and directors. A small Adventist hospital by good friend worked at had 9 administrators making more than $1 million/year, for example.